In many countries rates of prostate cancer cases and deaths have declined or stabilized. The United States had the largest recent decrease in disease incidence, a recent study says.
Previous studies have indicated significant variation in prostate cancer rates, due to factors including detection practices, availability of treatment, and genetic factors.
By comparing rates from different countries, the differences in detection practices can be assessed and improvements in treatment can be determined.
The researchers examined long-term and short-term data from 44 countries with incidence data and 71 countries with prostate cancer death data.
There were 44 countries assessed for incidence. Prostate cancer rates rose in four countries and fell in seven, with the United States with the biggest decrease. In the other 33 countries rates remained stable.
Of the 71 countries assessed for prostate cancer death rates, there were decreases in 14, increases in three, and no change in 54.
As of 2012, prostate cancer was the most commonly diagnosed cancer among men in 96 countries and the leading cause of death in 51 countries, according to the study.
The findings confirm the benefits of prostate-specific antigen (PSA) screening. In the United States, incidence rates rose from the 1980s to the early 1990s, then declined from the mid-2000s through 2015, largely due to increased use of PSA screening.
This type of screening is less available in poorer nations, meaning that men there are more likely to be diagnosed at later stages of prostate cancer and more likely to die.
Some nations plan to scale back recommendations for PSA screening due to fears about possible overtreatment of prostate cancer that would never cause symptoms.
The U.S. Preventive Services Task Force recommends that men aged 55 to 69 undergo periodic screening after they’ve discussed the risks and benefits with their doctor.
“The screening recommendations were changed recently after further analysis of the U.S. data and we are now seeing more high-risk prostate cancer diagnoses that require treatment.
Future studies may monitor trends in mortality rates and late-stage disease to assess the impact of reduction in PSA testing in several countries.